Glecaprevir

MAVYRET

Pronunciation: glek-A-pre-veer (MAV-i-ret)

What it isHCV NS3/4A protease inhibitor, given with pibrentasvir; chronic hepatitis C.

Why this onePangenotypic with an eight-week course in most treatment-naive patients, the shortest available.

What limits itContraindicated in decompensated cirrhosis. Hepatitis B reactivation; it inhibits P-gp, BCRP and OATP1B.

FDA-approved for

BOXED WARNING Risk of hepatitis B virus reactivation in HCV/HBV coinfected patients; can be fatal. Test all patients for HBV before treatment.

FDA dosing	Population	Start	Target	Max
Chronic hepatitis C (genotypes 1–6)	Adults	300 mg glecaprevir/120 mg pibrentasvir (3 tablets) QD		300 mg QD
Chronic hepatitis C (genotypes 1–6)	Peds 3 to <12 yr	Weight-based (pellets/tablets) QD

Renal No adjustment needed (any degree of impairment, including dialysis)

Hepatic Child-Pugh A: no adjustment; Child-Pugh B/C or prior hepatic decompensation: contraindicated

Available strengths

Moderate or severe hepatic impairment (Child-Pugh B or C) or any history of prior hepatic decompensation
Coadministration with atazanavir or rifampin

Pregnancy No adequate human data; no adverse developmental effects in animals at studied exposures.

Lactation Unknown whether excreted in human milk; present in animal milk without effects on nursing pups.

Glecaprevir (MAVYRET)

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $	brand $	CostPlus
100/40 mg	tab	30 qd	—	$4,589.50/mo	not offered
20/50 mg	pellet	per unit		—	not offered

⚠ BOXED WARNING

Principal riskHepatitis B reactivation; contraindicated in decompensated cirrhosis

Therapeutic safety burden2 / 4

Overdose danger1 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Legacy pregnancy categoryN/A (post-2015 labeling)

Defining liabilityHepatic decompensation in advanced liver disease and drug interactions

OATP substrate

P-gp substrate (sensitive)